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首页> 外文期刊>Surgical Endoscopy >Laparoscopic vertical banded gastroplasty for morbid obesity. Assessment of efficacy.
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Laparoscopic vertical banded gastroplasty for morbid obesity. Assessment of efficacy.

机译：腹腔镜垂直带状胃成形术用于病态肥胖。疗效评估。

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BACKGROUND: The advantages of treating morbidly obese patients via the laparoscopic approach have been demonstrated, in particular, for adjustable silicone gastric banding, but this operation is associated with a high rate of late complications. Gastric bypass and malabsorbitive procedures are feasible via the laparoscopic approach, but they entail a prolonged operating time and a consistently high morbidity rate. Laparoscopic vertical banded gastroplasty represents an effective alternative. METHODS: We performed 250 consecutive LVBG between November 1995 and February 2000. The procedure consisted of a personal technique designed to reproduce, by laparoscopy, MacLean's modification of the standard open Mason vertical-banded gastroplasty, with a calibrated transgastric window, a complete division between the staple lines, and a 5-cm-circumference polypropylene collar. RESULTS: The operative time was 95 min and the conversion rate was 0.8%. Operative mortality was nil; early and late complications, respectively, were 4.4% and 4%; the reoperation rate was 2%. Global results at 4 years were as follows: excess weight loss (EWL) 61%, success rate (excess weight <50%) 76.9%, body mass index (BMI) 29.4 kg/m2. In morbidly obese patients, the EWL at 4 years was 62.2%, with a 77.4% success rate and a 28.4 kg/m2 BMI; in superobese patients, the EWL at 4 years was 54.9% with a 50% success rate and a 35.5 kg/m2 BMI. The overall follow-up rate was 92%. CONCLUSIONS: LVBG is an effective and safe operation in morbidly obese patients, providing good weight loss with a low morbidity rate, no mortality, and minimum discomfort. However, in superobese patients, the weight loss results are disappointing; in these patients, LVBG is questionable and more complex procedures should be considered.
机译：背景：已经证明了通过腹腔镜方法治疗病态肥胖患者的优势，特别是对于可调节的硅胶胃束带，但这种手术与后期并发症的发生率高有关。通过腹腔镜方法可行胃旁路手术和吸收不良的程序，但是它们需要延长手术时间和持续较高的发病率。腹腔镜垂直条带化胃成形术是一种有效的选择。方法：我们在1995年11月至2000年2月之间连续进行了250次LVBG。该程序包括一项个人技术，该技术旨在通过腹腔镜检查对MacLean对标准开放式Mason垂直带状胃成形术进行修改，并带有经校准的经胃窗，订书钉线和5厘米周长的聚丙烯领。结果：手术时间为95min，转化率为0.8％。手术死亡率为零。早期和晚期并发症分别为4.4％和4％;再手术率为2％。 4年的总体结果如下：体重减轻（EWL）61％，成功率（体重超重<50％）76.9％，体重指数（BMI）29.4 kg / m2。在病态肥胖患者中，4年的EWL为62.2％，成功率为77.4％，BMI为28.4 kg / m2。在超肥胖患者中，4年的EWL为54.9％，成功率为50％，BMI为35.5 kg / m2。总体随访率为92％。结论：LVBG在病态肥胖患者中是一种安全有效的手术，可减轻体重，发病率低，无死亡率，且不适感最低。但是，对于超肥胖患者，减肥效果令人失望。在这些患者中，LVBG是有问题的，应考虑更复杂的程序。

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